Bad News on the Doorstep: Psychologists Prescribing Drugs

[Note: In this post, “APA” refers to the American Psychological Association]

There is an article in the current (July/August) issue of The National Psychologist titled “Iowa becomes 4th state to approve RxP”. The author is James Bradshaw, Associate Editor. RxP is a commonly used abbreviation for prescription authority for psychologists.

Here are some quotes from the article, interspersed with my comments.

“Iowa Gov. Terry E. Brandstad has signed a law granting prescription authority to properly trained psychologists, making Iowa the fourth state where psychologists can prescribe drugs from a psychotropic formulary.”

The three previous states to pass this measure are New Mexico, Louisiana and Illinois.

The article quotes Neal Morris, Ed.D., president of the American Society to Advance Pharmacotherapy, a division of the American Psychological Association.

“‘I am very excited and optimistic that in the near future other states will be enacting prescribing psychologist legislation,’ he said, adding, ‘RxP is such a good idea from the public health access to quality treatment standpoint I think it should be a top priority for every thoughtful legislator concerned about providing good health care to their constituents.'”

Katherine Nordal, PhD, APA’s Director for Professional Practice was also quoted:

“‘This is a landmark decision that will improve access to a wide range of mental health services'”

and

“Increasing access to mental health care is critical given the increase of major depressive disorders among Iowa’s youth and the number of people over 65 experiencing a diagnosable mental illness.”

This is straightforward psychiatric PR, coming from a psychologist! Note, in particular, the complete acceptance and endorsement of the spurious medical model.

. . . . . . . . . . . . . . . .

Bethe Lonning, Psy.D., represents the Iowa Psychological Association on the APA’s Council of Representatives, and was a prime leader in Iowa’s RxP movement. Dr. Lonning is quoted in the article:

“‘Signing this legislation into law is a great step toward increasing accessibility to mental health care for all Iowans, many of whom currently have to wait months or drive long distances to receive treatment.'”

Notice that, by implication, the word treatment is being used as synonymous with drug treatment.

The article continues:

“The dearth of psychiatrists in Iowa, particularly in rural areas, was a prime selling point to convince state legislators of the need for prescribing psychologists. There are no psychiatrists practicing in two-thirds of the state’s counties.”

This picture – of the misfortunate “mentally ill” people languishing unserved in the psychiatry-less wasteland – is, of course, pure PR. But I guess it was enough to convince the Iowa legislators.

. . . . . . . . . . . . . . . .

This, of course, is sad beyond words, but it reminded me of another article published in The National Psychologist eleven years ago (September/October 2005). The article was titled “The Decline and Fall of the American Psychological Association”. The author was the late George Albee, PhD, then professor emeritus of psychology at The University of Vermont. Here are some quotes:

“The decision by APA’s Council to proceed to seek prescription privileges for practicing psychologists is the final straw. We are doomed.”

“The pharmaceutical industry became top earners. They spread funds generously into organic psychiatry, brain research, training and public education. They sponsored drug research, wrote the results for the researchers, funded their journals and put everyone on as paid consultants.”

“Let us not misunderstand. Psychologists will get the legal authority to prescribe. They have the strong support of the powerful pharmaceutical industry. Psychologists can and will learn to be competent prescribers. But it will finally stamp us as an integral part of the invalid, unreliable medical explanation of emotional distress. Writing prescriptions for ‘drugs for the mind’ will cement us into a system from which there is no escape.”

“Being part of the system means supporting the system. So we must close our eyes, hold our noses and agree that half of all Americans will have a mental illness caused by a brain defect at some time in their lives. If judged incompetent they can be forced by law to take their pills.”

“In spite of years of seeking, no organic pathology has been found that causes mental disorders and diagnoses for these conditions are unreliable and hence invalid. Organic (drug) treatment does not cure mental disorders. But to work in the field it is necessary to support all these myths and dishonesties.”

“A few competent and informed journalists could expose the flimsy and invalid evidence on which the current model depends. We need more like A. Deutsch (1948) who, in The Shame of the States, brought attention to the horrible inhumanity of the state hospitals. R. Whitaker (2002) has made a start, but he cannot compete with the powerful citizens’ groups such as the National Alliance for the Mentally Ill (NAMI), mostly relatives of seriously disturbed people.”

Albert Deutsch (1905-1961) was an American journalist and social historian. The Robert Whitaker book Dr. Albee references is Mad in America, and in the eleven years since George Albee wrote these words, Robert Whitaker’s work has progressed way beyond “a start”.

“NAMI fiercely defends the brain diseases model and goes ballistic to any suggestion that social conflicts could play any role in causation. The National Alliance for Research on Schizophrenia and Depression holds formal balls to showcase its upper-class contributors but denies the clear evidence that schizophrenia is not a disease (Boyle) and that depression is unknown in many cultures.”

The Boyle reference is to Mary Boyle’s cardinal work: Schizophrenia: A Scientific Delusion? (1990). Dr. Boyle is a British clinical psychologist, and Professor Emeritus at University of East London. A second edition of the book was published in 2002.

. . . . . . . . . . . . . . . .

Also in 2005, Dr. Albee wrote this in a letter to the Independent Practitioner, an APA publication:

“To prescribe drugs as treatment changes fundamentally our orientation as a profession. We now become part of a group that sees emotional behavioral disturbance as biological defect or glandular irregularity to be corrected with chemicals. Our long history of research into the damage done by toxic relationships in the past, and the ways these can be mended by relearning, is abandoned.”

and

“I do indeed think we have sold our soul for money in accepting the medical model of emotional disorder.”

George Albee died on July 8, 2006, at his home in Longboat Key, Florida. He was 84. During his life he had written tirelessly and cogently against the medicalization of human distress.

. . . . . . . . . . . . . . . .

Four states plus the US military now allow psychologists the authority to prescribe psychiatric drugs. More states will certainly follow, and the profession that should be most aware of, and most outraged by, the psychiatric hoax will soon be fully integrated into the spurious, disempowering, and destructive system.

To state the obvious, psychology is a split profession. On the one hand, there are those who accept the illness model, believe that the “diagnoses” have some ontological and explanatory significance, and embrace “pharmacotherapy” as a valid and ethical way to address problems of thinking, feeling, and behaving. On the other hand, there are those of us who reject these premises as spurious and unequivocally harmful. The split has been long evident. For decades the two factions have worked alongside each other with a reasonable level of collaboration and a semblance of mutual respect. But the conflicts are being exposed in sharper relief as the medicalization proponents continue to expand their prescriptive authority. I doubt that a profession can contain this kind of internal tension indefinitely, and perhaps the day is approaching when we will have two very different kinds of psychologists: the druggers and the non-druggers. Though I’m sure that different terminology will be used.

It is customary in these sorts of circumstances to lament the schism and express the hope that the two sides can “iron out” their differences. But just as the rift between psychiatry and anti-psychiatry is irremediable, so there can never be any substantive common ground between psychologists who embrace and promote a medical model of human distress and those who do not. To adapt Dr. Albee’s metaphor: people can close their eyes and hold their noses for only so long.

The philosophy and practice that psychiatry has created within the mental heath system, public and private, is a spurious, destructive, self-serving travesty. It is also a tyranny that demands of its “ancillary staff” acceptance of, and compliance with, the biological medical model. Staff members who don’t accept the doctrine are marginalized, ridiculed, or worse. In a recent post on Mad In America, Michael Rock, psychotherapist, vividly described his experiences in this area as he struggled with the obvious invalidity and lack of efficacy of the psychiatric system.

The reality is that as psychiatry, beleaguered as it is, doubles down on its spurious and destructive premises, routinely substituting PR and unsubstantiated assertions for logic and evidence, more and more “ancillary staff” will see through the hoax. The emperor really and truly has no clothes. Organized psychology and some of its members are willing to play along for the sake of the crumbs that fall from the table. But what of the other professions: the social workers, counselors, case managers, job coaches, etc.? These are the people who spend the most time with the clients. These are the people who know that there is something terribly wrong with the system, but who dare not speak out, for fear of ostracization or even loss of livelihood.

The “chemical imbalance” part of the hoax has been successfully outed. It’s only a matter of time before the rest of the shabby enterprise follows suit. And as psychiatrists are increasingly exposed as the destructive, self-serving, drug-pushers that they are, psychologists who pursued the primrose path of “psychopharmacotherapy” will inevitably find themselves tarred with the same brush.

About Phil Hickey

I am a licensed psychologist, presently retired. I have worked in clinical and managerial positions in the mental health, corrections, and addictions fields in the United States and England. My wife Nancy and I have been married since 1970 and have four grown children.

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